NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
75573 Ct scan of congenital heart disease with contrast CPT · CT Scan imaging
Classification Imaging › CT Scan › CT/CTA - Chest (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 498 services ▲ 191.2% YoY · 490 beneficiaries (CY2024, Medicare FFS)
Medicare paid $55K · $111.11 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

5

Named groups billing this code
Named-group FFS services

93

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+191.2%

FFS enrollment -2.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~187 services

93 observed fee-for-service (50%) · ~94 estimated Medicare Advantage.

Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — 75573 (CY2024)
MA 219 NY 114 LA 54 CA 43 VA 18

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Billed → allowed → paid
Named-group submitted charges
$73K
Named-group allowed amount
$16K
Named-group Medicare payments
$13K
Avg charge / svc
$782
Avg allowed / svc
$175
Avg payment / svc
$138
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$317 5 groups · avg submitted charge / service $1,272
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 75573 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 CARDIOVASCULAR INSTITUTE OF THE SOUTH, LLC LAFAYETTE LA NURSE PRACTITIONER 142 35 $44,520 $1,272 64.8% (337) 289-8429
2 REGENTS OF THE UNIV OF CA SACRAMENTO CA DIAGNOSTIC RADIOLOGY 1608 21 $14,910 $710 48.8% (877) 827-7463
3 PHYSICIANS REFERRAL SERVICE HOUSTON TX NURSE PRACTITIONER 2696 14 $4,438 $317 100.0% (713) 592-5433
4 HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC BOSTON MA INTERNAL MEDICINE 1689 12 $4,848 $404 5.5% (781) 983-9088
5 GUAM HEALTHCARE DEVELOPMENT INCORPORATED DEDEDO MA DIAGNOSTIC RADIOLOGY 210 11 $4,026 $366 5.0% (671) 645-5500

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →